This is the eighth post in our Winter 2013 blog series Understanding Depression in Kids and Teens…A Primer for Pastors, Church Staff and Christian Parents. Today, we’ll share practical advice for families who suspect their child may be experiencing depression and are beginning the search to find the right help.

Families in the church face an additional burden in seeking help when a child or teen needs help for depression. Accurate data is hard to come by, but a significant percentage of adults will first seek help from a pastor or counselor through their church when struggling with emotional issues. It’s been my experience that many churches offer reasonably good short-term counseling and support for adults, but very few will have staff with adequate training or supervision in counseling children or teens. So…where does a parent go to find the right help when they suspect their child needs help for depression?

A couple of years ago, we addressed the topic of whether Christian parents should only seek help from mental health professionals. The conclusions we came to were:

• You might be waiting for a very long time to get help if you insist upon seeing a specialist in child and adolescent psychiatry or pediatric psychology who is also Christian… especially an evangelical Christian. Mental health professionals with formal training and experience in treating children are in very short supply and Christians (especially from more theologically conservative denominations) are enormously underrepresented in the field.

• The critical issue for parents who have a kid in need of mental health care is finding a clinician with a track record of demonstrating excellence in what they do, as long as they’re willing to respect your family’s belief system.

The right person is likely to be someone who will take the time not just to determine “what” condition your child is experiencing, but to understand WHY they’re experiencing symptoms and develop an appropriate treatment plan on the basis of that understanding. They’ll want to do detailed interviews with both parents (if available) along with taking the time to get to know your child, and they’ll possibly be interested in observations from other significant adults in your child’s life. They’ll be interested in your child’s academic progress. They’ll want to know about family history, especially if they suspect your child might have a mood disorder. They’ll be knowledgable about the full range of evidence-based treatments and have ongoing working relationships with other professionals if there are important treatments they themselves don’t offer.

The next question that arises has to do with identifying a professional within the appropriate discipline (psychiatrists vs. psychologists vs. counselors vs. marriage and family therapists vs. pastoral counselors). Here’s a nice resource from the American Academy of Child and Adolescent Psychiatry explaining some of the differences. In general, if your child is experiencing significant sadness or anxiety and they’re not experiencing significant physical symptoms associated with their condition, or if you’re unwilling to consider medication as part of a more comprehensive treatment plan, it’s not unreasonable to start with a psychologist or counselor. You would want to find someone with evidence of formal training or supervision in cognitive-behavioral therapy if you suspect they might be depressed or anxious. If your child also has significant learning problems, I’d lean toward a psychologist, because many also have training and experience in performing the testing batteries necessary to identify learning disabilities. The more complex your child’s condition and the more severe their symptoms, the more likely you are to want to start with a child and adolescent psychiatrist (MD).

Given the prevalence of mental health conditions among teens, many parents rely upon recommendations from friends when seeking help. If I had to guess, I’d say that between 30-50% of our new patients come via recommendations from parents of kids we’ve treated. In addition to other parents, I’d consider seeking recommendations from…

• The children’s pastor, youth pastor or counseling pastor at your church, assuming you’re comfortable discussing mental health concerns with them.
• Your child’s pediatrician or family physician.
• Your child’s school psychologist or guidance counselor, again assuming you’re comfortable discussing mental health concerns with school personnel.
• Your employee assistance plan (EAP), if you have one.
• Your local mental health board, or local chapter of a mental health advocacy organization (NAMI).

There’s a very good possibility that you may need to go outside your health insurance network to find the help you need for reasons that we described here. Above all, remember that God loves your child even more than you do and pray that His purposes will be fulfilled through your family being guided to the right help.

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